General Dentistry

TOOTH DECAY PREVENTION

Tooth decay is often called the second most prevalent human disease, after the common cold. Without effective treatment (as was the case through most of history) it can lead to pain, tooth loss, and sometimes worse illnesses. Even today, it’s estimated to affect over a quarter of U.S children from ages two to five, and half of those aged 12-15. But it doesn’t necessarily have to! Working together with our office, you can take steps to prevent tooth decay from harming your teeth — or those of your loved ones.

There’s one important fact you should understand up front: No single “magic bullet” can stop tooth decay in every case. Instead, fighting decay should be viewed as a process of preventive maintenance, like taking care of your car — except that (unlike a car) your natural teeth, with proper care, can last a whole lifetime. The basic aspects of this process are practicing good oral hygiene at home, and coming in to our office for regular cleanings and checkups.

If you’ve been coming in for routine visits, you’re probably already familiar with the special tools we use to remove buildups of plaque (a bacterial biofilm) and tartar (a hardened deposit, also called calculus) from your teeth. We may use hand-held instruments, ultrasonic scalers, or both to give your teeth a thorough cleaning. Afterwards, we check thoroughly for decay, and treat cavities when necessary.

Yet there’s still more we can do to prevent tooth decay. Could your diet be a contributing factor? Is your brushing technique adequate? Could you benefit from additional preventive treatments? Today, with our increased understanding of what causes tooth decay and how to treat it, we can truly focus on decay prevention in your particular case. In fact, it’s now possible to assess each individual’s risk factors for decay, and concentrate on doing what’s most effective for you.

How does decay start?

How does decay start?

We think of the mouth as a dynamically balanced ecosystem, in which living organisms, including helpful and harmful bacteria, are constantly interacting. When conditions are right — namely, in the presence of certain sugars — some pathogenic (harmful) bacteria produce acids that cause teeth to lose minerals and begin breaking down. Even a diet having excessive acidic foods can influence deminerialization of your teeth. But in more favorable conditions, the damage these pathogens do is undone by the body’s own healing mechanisms — which includes your healthy saliva.

Our goal in decay prevention is to tip the balance in favor of the beneficial processes. Keeping up a regular habit of brushing and flossing, getting adequate fluoride, and a diet with limited acidic foods is certainly helpful. Yet even with these measures, some individuals will be more prone to tooth decay than others, and may need extra help and guidance.

Additional Steps to Prevent Tooth Decay

Additional Steps to Prevent Tooth Decay

If you’re one of these individuals, we can demonstrate effective brushing techniques and recommend other steps you can take at home, like using special tooth pastes or rinses. When necessary, in-office treatments such as topical fluoride applications are available. If you aren’t getting enough fluoride through drinking water or other sources, this treatment can help prevent tooth decay. Anti-bacterial treatments may also be beneficial in some cases, as is nutritional counseling.

Dental Sealants.Finally, if your child’s teeth are susceptible to tooth decay, we can apply a dental sealant. This is a practically invisible layer of plastic resin that is placed on the top (chewing) surfaces of the back teeth. It’s a painless procedure that fills in the natural pits and folds of the tooth, making them much more resistant to bacterial damage.

So, don’t think that tooth decay is inevitable — instead, come in and ask us what we can do together to help prevent this disease from affecting you or your loved ones.

Common Problems

Common Problems

Tooth Decay

Caries, or tooth decay, is a preventable disease. While caries might not endanger your life, they may negatively impact your quality of life.

When your teeth and gums are consistently exposed to large amounts of starches and sugars, acids may form that begin to eat away at tooth enamel. Carbohydrate-rich foods such as candy, cookies, soft drinks and even fruit juices leave deposits on your teeth. Those deposits bond with the bacteria that normally survive in your mouth and form plaque. The combination of deposits and plaque forms acids that can damage the mineral structure of teeth, with tooth decay resulting.

Sensitive Teeth

Your teeth expand and contract in reaction to changes in temperature. Hot and cold food and beverages can cause pain or irritation to people with sensitive teeth. Over time, tooth enamel can be worn down, gums may recede or teeth may develop microscopic cracks, exposing the interior of the tooth and irritating nerve endings. Just breathing cold air can be painful for those with extremely sensitive teeth.

Gum Disease

Gum, or periodontal, disease can cause inflammation, tooth loss and bone damage. Gum disease begins with a sticky film of bacteria called plaque. Gums in the early stage of disease, or gingivitis, can bleed easily and become red and swollen. As the disease progresses to periodontitis, teeth may fall out or need to be removed by a dentist. Gum disease is highly preventable and can usually be avoided by daily brushing and flossing. One indicator of gum disease is consistent bad breath or a bad taste in the mouth.

Click Here to see why we may need to exam and clean your teeth every three months.

Bad Breath (Halitosis)

Daily brushing and flossing helps to prevent the build-up of food particles, plaque and bacteria in your mouth. Food particles left in the mouth deteriorate and cause bad breath. While certain foods, such as garlic or anchovies, may create temporary bad breath, consistent bad breath may be a sign of gum disease or another dental problem.

Canker Sores

Canker sores (aphthous ulcers) are small sores inside the mouth that often recur. Generally lasting one or two weeks, the duration of canker sores can be reduced by the use of antimicrobial mouthwashes or topical agents. The canker sore has a white or gray base surrounded by a red border.

Orthodontic Problems

A bite that does not meet properly (a malocclusion) can be inherited, or some types may be acquired. Some causes of malocclusion include missing or extra teeth, crowded teeth or misaligned jaws. Accidents or developmental issues, such as finger or thumb sucking over an extended period of time, may cause malocclusions.

Emergency Info

Tooth Ache

Begin by cleaning around the sore tooth meticulously. Using warm salt water, rinse the mouth to displace any food trapped between teeth. Under no circumstances should you use aspirin on the aching tooth or on the gum. In the event of facial swelling, apply a cold compress to the area. For temporary pain relief, acetaminophen is recommended. Please contact us for an appointment if the pain persists more than a day.

Possible Broken Jaw

In the event of jaw injury, tie the mouth closed with a towel, tie or handkerchief. Go immediately to an emergency room.

Broken Tooth

Rinse the area with warm water. Put a cold compress over the facial area of the injury. Recover any broken tooth fragments. Seek immediate dental attention.

Bleeding After a Baby Tooth Falls Out

Fold a piece of gauze and place it (tightly) over the bleeding area. Bite down on the gauze for 15 minutes. If bleeding continues, see a dentist.

Cut or Bitten Tongue, Lip or Cheek

Ice can be applied to any bruised areas. For bleeding, apply firm (but gentle) pressure with sterile gauze or a clean cloth. If the bleeding does not stop with pressure or continues after 15 minutes, go to an emergency room.

Knocked Out Permanent Tooth

Recover the tooth, making sure to hold it by the crown (top) and not the root. Rinse, but do not clean or handle the tooth more than necessary. Reinsert the tooth in the socket, and hold it in place using a clean piece of gauze or cloth. If the tooth cannot be reinserted, carry it in a cup containing milk or water. Because time is essential, see a dentist immediately.

General Dental Services

Our practice can provide a wide range of dental services. We can typically provide every type of dental service without having to refer you to other specialties. This flexibility saves you time and keeps your total dental care within one practice. Our emphasis is on total preventive care for our patients. Total care begins with regular hygiene visits, regular checkups and continued home oral health routines.

Our practice also provides the highest-quality services for restoring mouths that have been damaged by dental disease and injury and common problems that require cosmetic dentistry. Our primary goal for our patients is to achieve and maintain optimum oral health through advances in techniques, technologies and by maintaining their scheduled dental exams.

Teeth Cleanings

Teeth Cleanings

Twice a year, you should schedule a routine dental cleaning. During this visit, one of our dental hygienists will remove plaque from your teeth, especially from places where your brush can’t reach, such as underneath the gum line and in-between teeth. We will then clean your teeth and apply fluoride to help protect your teeth once you leave the office.

Fluoride is a relatively recent but important advancement in dental and oral health. Studies consistently show that a moderate but consistent exposure of teeth to fluoride helps strengthen and rebuild tooth structure, and helps prevent future decay.

If you are due for your semi-annual dental cleaning, please call our office to schedule an appointment.

Fillings

Fillings

The concept of a “filling” is replacing and restoring your tooth structure that is damaged due to decay or fracture with a material. We will replace old, broken-down amalgam/metal fillings that contain traces of mercury with white fillings (composites) to restore your smile and teeth to a more natural look and feel.

With today’s advancements, no longer will you have to suffer the embarrassment of unsightly and unhealthy silver/mercury fillings or metal margins of the past. Eliminate the dark, black appearance in your teeth with new-age, state-of-the-art, tooth-colored resin or porcelain materials.

Crowns

Crowns

A crown is a custom-made covering that fits over an original tooth that is either decayed, damaged or cracked. Crowns are made of a variety of different materials such as porcelain, gold, acrylic resin or a mix of these materials. Porcelain generally has the most natural appearance, although it is often less durable.

The treatment plan for a patient receiving a crown involves:

1. Numbing the tooth to remove the decay in or around it.
2. Re-sculpturing the tooth to provide an ideal fit for the crown.
3. Making an impression of your teeth in order to create a custom-made crown (usually takes one to two weeks).
4. Making a temporary crown out of acrylic resin and fitting it onto the tooth during the interim period when the custom-made crown is being created.
5. Applying the custom-made crown (when received from the lab) by removing the temporary crown and fitting the custom-made one onto the tooth.
6. After ensuring that the crown has the proper look and fit, the dentist cements it into place.
This process generally consists of a minimum of two to three visits over a three to four week period. Once the procedure is completed, proper dental hygiene, including daily brushing and flossing, is required to maintain healthy, bacteria-free teeth, gums and crowns. This helps in the prevention of gum disease. Given proper care, your crowns can last a lifetime.

Bridges

Bridges

A bridge is a dental device that fills a space that a tooth previously occupied. A bridge may be necessary to prevent:

Shifting of the teeth that can lead to bite problems (occlusion) and/or jaw problems and resultant periodontal disease.
Bridges safeguard the integrity of existing teeth and help maintain a healthy, vibrant smile.
There are three main types of bridges, namely:

A fixed bridge is the most popular and consists of a filler tooth that is attached to two crowns, which fit over the existing teeth and hold the bridge in place.
The “Maryland” bridge is commonly used to replace missing front teeth and consists of a filler that is attached to metal bands that are bonded to the abutment teeth. The metal bands consist of a white-colored composite resin that matches existing tooth color.
The cantilever bridge is often used when there are teeth on only one side of the span. A typical three-unit cantilever bridge consists of two crowned teeth positioned next to each other on the same side of the missing tooth space. The filler tooth is then connected to the two crowned teeth, which extend into the missing tooth space or end.

General Extractions

General Extractions

An extraction is the complete removal of a tooth. Extractions are sometimes necessary if a primary tooth is preventing the normal eruption of a permanent tooth, if the tooth has suffered extensive tooth decay or trauma that cannot be repaired, if the patient has gum disease, or if the tooth is impacted (usually the wisdom teeth). Depending on the complexity of the case, an extraction can be performed surgically or non-surgically. A mild anesthesia is used to ensure you or your child is as comfortable as possible throughout the procedure.

Wisdom Teeth

Wisdom Teeth

Your third molars are more commonly called “wisdom teeth.” Usually appearing in the late teens or early twenties, third molars often lack the proper space in the jaw to erupt fully or even at all. This common condition is called impaction. When any tooth lacks the space to come through or simply develops in the wrong place of your jaw and becomes impacted, problems can arise. Primarily, damage to adjacent teeth and crowding occur.

In certain cases, the wisdom tooth that cannot come through becomes inflamed under the gums and in the jawbone, causing a sac to develop around the root of the tooth that then fills with liquid. This can cause a cyst or an abscess if it becomes infected. If either of these situations goes untreated, serious damage to the underlying bone and surrounding teeth and tissues can result.

To potentially stave off this result, an extraction of one, several or all of the wisdom teeth may be advised. If that is the case, we have the equipment and training needed to perform such extractions, with an absolute minimum of discomfort. Ask our staff for more information regarding tooth extractions if you feel you may need one.

Root Canals

Root Canals

A root canal is a procedure that extracts decayed pulp from the central part of the tooth, reshapes the canal and replaces it with strengthening filler.

A cavity is the result of superficial decay of the enamel of the tooth. Left long enough, this decay can burrow into the deeper reaches of the tooth, causing extensive damage to tooth structure. When the damage goes beyond what can be treated with a filling, dentists can perform a root canal (or endodontics), preserving the tooth and retaining its original integrity; thereby, saving a tooth that in the past would have to have been pulled.

Procedure:

1. The patient undergoes anesthesia.
2. A dental dam is used to isolate the tooth.
3. The tooth is opened to allow for removal of infected or dead dental pulp.
4. The tooth is comprehensively cleaned, including any cracks and canals.
5. With special tools, the doctor reshapes the canals.
6. The tooth is filled again with cutting edge biocompatible filling material.
7. A temporary covering is used to cover the access opening.
8. Patients MUST see their regular dentist quickly for a permanent restoration of the tooth.

Temporomandibular Joint Disorder TMD/TMJ

Causes of TMJ

As with any other joint, the TMJ can be subject to orthopedic problems including inflammation, sore muscles, strained tendons and ligaments, and disk problems. We also know that TMD is influenced by genes, gender (women appear to be more prone to it), and age. Physical and psychological stress can also be a factor. In some cases, jaw pain may be related to a more widespread, pain-inducing medical condition such as fibromyalgia (“fibro” – connective tissues; “myo” – muscle; “algia” – pain).

Signs and Symptoms of TMD

Signs and Symptoms of TMD

Clicking Sounds — Some people with TMD hear a clicking, popping or grating sound coming from the TMJ when opening or closing the mouth. This is usually caused by a shifting of the disk inside the joint. Someone standing next to you might even be able to hear it. Clicking by itself is actually not a significant symptom because one third of all people have jaw joints that click, studies show. However, if the clicking is accompanied by pain or limited jaw function — the jaw getting “stuck” in an open or closed position, for example — this would indicate TMD.

Kids mouth anatomy.
Muscle Pain — This can be felt in the cheeks (masseter muscles) and temples (temporalis muscles), where the two big pairs of jaw-closing muscles are located. If you feel soreness and stiffness upon waking up in the morning, it’s often related to habits such as clenching and/or grinding the teeth at night. If you have this type of nocturnal habit, we can have a nightguard custom-made for you that should be very helpful in decreasing the force applied to your teeth, which will in turn allow your muscles to relax and relieve pressure on your jaw joints. Other self-care remedies are discussed below (please see Relieving the Pain).

Joint Pain — Pain that’s actually coming from one or both jaw joints technically would be described as arthritis (“arth” – joint; “itis” – inflammation) of the TMJ. When we look at radiographs (x-ray pictures) we find that some people have arthritic-looking TMJs but no symptoms of pain or dysfunction; others have significant symptoms of pain and dysfunction but their joints look normal on radiographs. There is no cure for arthritis anywhere in the body, but medication can sometimes help relieve arthritic symptoms.

Relieving the Pain

Relieving the Pain

Once we examine you, we will come up with a strategy for treating your condition and managing your pain. Sometimes a temporary change to a softer diet can reduce stress on the muscles and joints. Ice and/or moist heat can help relieve soreness and inflammation. Muscles in spasm can also be helped with gentle stretching exercises. Non-steroidal anti-inflammatory medications and muscle relaxants can also provide relief.

Other Treatment Options

Other Treatment Options

Severe TMD cases may require more complex forms of treatment, which might include orthodontics, dental restorations like bridgework, or minor procedures inside the joint such as cortisone injections or lavage (flushing) of the joint. It’s rare for major surgery ever to be necessary in a case of TMD. Again, it’s important to try the wide range of conservative, reversible treatments available, and give them enough time to work as they almost always prove effective. The first step is an examination here at our dental office. We don’t want you to be in pain, so please come in and see us. To learn more about the treatment options available, view our Chart on TMD Therapy

Root Canal

Root canal treatment — also called endodontics (“endo” – inside, “dont” – tooth) — is a set of specialized procedures designed to treat problems of the soft pulp (nerve) tissue inside the tooth. While some mistakenly think of it as an unusually painful treatment, in most cases the procedure is no more uncomfortable than getting a filling. It’s actually one of the most effective ways of relieving some kinds of tooth pain.

A root canal procedure becomes necessary when infection or inflammation develops in the pulp tissue of the tooth. Pulp tissue consists of blood vessels, connective tissue and nerve cells — which explains why a problem here may cause you to feel intense pain. In time, the pain may go away… at least temporarily. Without treatment, however, the infection won’t. It can lead to a dental abscess, and may even contribute to systemic problems in other parts of the body.

Signs and Symptoms of Root Canal Problems

Signs and Symptoms of Root Canal Problems

How do you know when you need a root canal? Sometimes, it’s painfully obvious. If you feel constant and severe pain and pressure in your mouth, or noticeable swelling and extreme sensitivity in your gums, then it’s clear you need to come in for evaluation and treatment right away. Another telltale symptom of pulp tissue damage is sharp pain when you bite down on food. Lingering pain after eating hot or cold foods is also an indication of potential trouble. If you notice any of these symptoms, please come in for an examination.

Root canal treatment is your friend

Root canal treatment is your friend

We’ve all heard the gag: “I’d rather have a root canal…” This comedy line, comparing the procedure to something truly undesirable, may be funny — but putting off needed endodontic treatment is no joke. The idea that a root canal procedure invariably comes with complications and pain is a shopworn myth. It’s certainly true that infection or inflammation in the tooth’s pulp can be excruciatingly painful. But you should remember that having a root canal results in eliminating this acute pain and is not the cause of the pain.

Need another reason not to delay root canal treatment? How about this: A natural tooth that’s saved via root canal treatment and restoration helps you avoid the problems that commonly occur when teeth must be removed. These include unwanted tooth migration or shifting, which can lead to difficulties in chewing; the need for bridgework or dental implants, which may be costly and complicated; and even the eventual loss of bone structure from the area of the missing tooth.

Causes of Root Canal Problems

Causes of Root Canal Problems

Root canal problems stem from infection and inflammation of the tooth’s pulp tissue. One potential cause of infection is deep tooth decay. Untreated dental cavities eventually allow bacteria to work their way down to the center of the tooth, where they may infect the pulp tissue. Another path by which bacteria may come into contact with pulp is via chipped or cracked teeth. Any opening in the protective enamel coating has the potential to allow bacteria access to the tooth’s pulp.

Trauma to the tooth — the kind that might result from a sports injury or automobile accident, for example — is also a major cause of pulp tissue damage. In this case, it’s essential to seek treatment immediately, both to try and save the tooth, and to prevent future problems.

In some cases, extensive dental work itself may cause damage to the pulp tissue that will need to be treated via a root canal. Having multiple fillings or restorations on the same tooth increases the chances of this type of injury. Occasionally, common procedures like crown preparation or orthodontics may eventually lead to root canal problems.

What to Expect During Root Canal Therapy

What to Expect During Root Canal Therapy

If an examination shows that you do need root canal therapy, don’t worry — it’s one of the most routine and effective procedures in the arsenal of dental treatments and can often be accomplished in just one visit.

The root canal process generally begins the same way as a filling does, and with no greater discomfort: an anesthetic is administered to numb the tooth and the surrounding area. For many patients, the worst is already over.

Tooth after root canal treatment.
Next, a small opening is made in the surface of the affected tooth to give access to the pulp chamber and root canals. Tiny instruments are used, sometimes with the aid of a microscope, to remove the dead and dying pulp tissue from inside these narrow passageways. The chamber and empty canals are then cleaned, disinfected, and prepared to receive a filling of inert, biocompatible material. Finally, adhesive cement is used to seal the opening in the tooth, preventing future infection.

Following root canal treatment, your tooth may feel some sensitivity or tenderness for a few days. Over-the-counter pain relievers like ibuprofen are generally effective in relieving discomfort, but prescription medications may also be given if needed. During this period, it may help to avoid biting hard on the affected tooth. All of these symptoms, however, should be temporary.

To further protect the tooth and restore it to full function, it’s usually necessary to have a crown or other restoration placed on it. Restorations can take many forms, from traditional gold crowns to tooth replicas made of high-tech tooth-colored material. In any case, you will have made an investment in preserving your dental health for years to come.